To save content items to your account,
please confirm that you agree to abide by our usage policies.
If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account.
Find out more about saving content to .
To save content items to your Kindle, first ensure firstname.lastname@example.org
is added to your Approved Personal Document E-mail List under your Personal Document Settings
on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part
of your Kindle email address below.
Find out more about saving to your Kindle.
Note you can select to save to either the @free.kindle.com or @kindle.com variations.
‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi.
‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.
In 2017, Public Health England South East Health Protection Team (HPT) were involved in the management of an outbreak of Mycobacterium bovis (the causative agent of bovine tuberculosis) in a pack of working foxhounds. This paper summarises the actions taken by the team in managing the public health aspects of the outbreak, and lessons learned to improve the management of future potential outbreaks. A literature search was conducted to identify relevant publications on M. bovis. Clinical notes from the Public Health England (PHE) health protection database were reviewed and key points extracted. Animal and public health stakeholders involved in the management of the situation provided further evidence through unstructured interviews and personal communications. The PHE South East team initially provided ‘inform and advise’ letters to human contacts whilst awaiting laboratory confirmation to identify the infectious agent. Once M. bovis had been confirmed in the hounds, an in-depth risk assessment was conducted, and contacts were stratified in to risk pools. Eleven out of 20 exposed persons with the greatest risk of exposure were recommended to attend TB screening and one tested positive, but had no evidence of active TB infection. The number of human contacts working with foxhound packs can be large and varied. HPTs should undertake a comprehensive risk assessment of all potential routes of exposure, involve all other relevant stakeholders from an early stage and undertake regular risk assessments. Current guidance should be revised to account for the unique risks to human health posed by exposure to infected working dogs.
Hill (Twin Research and Human Genetics, Vol. 21, 2018, 84–88) presented a critique of our recently published paper in Cell Reports entitled ‘Large-Scale Cognitive GWAS Meta-Analysis Reveals Tissue-Specific Neural Expression and Potential Nootropic Drug Targets’ (Lam et al., Cell Reports, Vol. 21, 2017, 2597–2613). Specifically, Hill offered several interrelated comments suggesting potential problems with our use of a new analytic method called Multi-Trait Analysis of GWAS (MTAG) (Turley et al., Nature Genetics, Vol. 50, 2018, 229–237). In this brief article, we respond to each of these concerns. Using empirical data, we conclude that our MTAG results do not suffer from ‘inflation in the FDR [false discovery rate]’, as suggested by Hill (Twin Research and Human Genetics, Vol. 21, 2018, 84–88), and are not ‘more relevant to the genetic contributions to education than they are to the genetic contributions to intelligence’.
There are few evaluations of strategies to improve rates of early
detection and treatment of patients with first-episode psychosis
To evaluate the effectiveness of a general practitioner (GP) education
programme and an early detection assessment team (the Lambeth Early Onset
Crisis Assessment Team; LEO CAT) in reducing delays in accessing
treatment for first-episode psychosis patients.
46 clusters of GP practices randomised to GP education in early detection
with direct access to LEO CATv. care as usual. Primary
outcome measures were GP referral rates, duration of untreated psychosis
(DUP) and delays in receiving treatment. Results 150
patients with first-episode psychosis were recruited; 113 were registered
with the study GPs, who referred 54 (47.7%) directly to mental health
services. Significantly more intervention group GPs (86.1%
v. 65.7%) referred their patients directly to mental
health services and fewer patients experienced long delays in receiving
treatment. However, their overall DUP was unaffected
Educating GPs improves detection and referral rates of first-episode
psychosis patients. An early detection team reduces the long delays in
initial assessment and treatment. However, these only impact on the later
phases of the DUP. Broader measures, such as public health education, are
needed to reduce the earlier delays in DUP.
Although there is good evidence that interventions for carers of people with Alzheimer's disease can reduce stress, no systematic studies have investigated psychotherapeutic intervention for patients themselves. This may be important in the earlier stages of Alzheimer's disease, where insight is often preserved.
The aim was to assess, in a randomised controlled trial, whether psychotherapeutic intervention could benefit cognitive function, affective symptoms and global well-being.
Individuals were randomised to receive six sessions of psychodynamic interpersonal therapy or treatment as usual; cognitive function, activities of daily living, a global measure of change, and carer stress and coping were assessed prior to and after the intervention.
No improvement was found on the majority of outcome measures. There was a suggestion that therapy had improved the carers' reactions to some of the symptoms.
There is no evidence to support the widespread introduction of brief psychotherapeutic approaches for those with Alzheimer's disease. However, the technique was acceptable and helpful individually.
The analysis of Bronze Age barrow sites excavated as long ago as 25 years can provide information on more significant and wide ranging topics than basic funerary rites. At Buckskin no primary burial rite was recorded nor any high status artefacts found. The analysis, of stored soil samples and animal bones however, produced evidence for ceremonial activity and feasting prior to the construction of the barrow mound. This encourages discussion on both the role of this barrow and the primary function, other than interment, of similar monuments, especially from the evidence of environmental data. Study of both land Mollusca and faunal remains enabled a greater explanation of the cultural history of this monument and aided the site phasing.
The intakes of concentrates and hay by individuals in three groups of ewes were estimated at three-weekly intervals in late pregnancy from faecal output; chromic oxide was incorporated as a marker in the concentrates. The groups were: (1) 16 mature ewes, (2) 16 2-year-old ewes, (3) eight mature and eight 2-year-old ewes. A constant daily hay allowance of 734 g dry matter (DM)/sheep was given but the concentrate was increased from an equivalent of 96 g DM/sheep at the beginning of the experiment to 435 g at the end. Individual concentrate intakes were most variable when the group allowance was small (CV over 50% in the mixed group) but variation decreased when amounts of concentrates were increased to contribute up to 47% of the total digestible DM intake. The CV for the total digestible DM intake ranged from 13 to 24%.
The younger sheep were at no disadvantage when penned with mature ewes. Intakes by individual ewes were compared with their calculated requirements and several twin-bearing ewes were shown to have a substantial energy deficit which was confirmed by their higher plasma ketone concentrations.
A major practical difficulty in group-feeding pregnant ewes is to ensure that the ewes with the highest foetal burden are adequately fed.
Email your librarian or administrator to recommend adding this to your organisation's collection.